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Universe Monitoring Service Case Study and Service Spotlight

By March 18, 2020March 26th, 2020CMS, IDS, Part C, Part D, UMS

Many of the proposed audit protocol changes for both the 2020 and 2021 audit season included changes to universes. An incomplete and incorrect universe can add 1 point toward your CMS Program Audit score and take a whole lot more from your bottom line.  It is critical that you are conducting quality reviews and analyzing your universes on a regular basis, but the reality is that universe monitoring competes with the organization’s other priorities and resources and gets pushed to the back burner. Which is why BluePeak developed our Universe Monitoring Service (UMS), an audit-readiness resource for plans.

BluePeak’s Universe Monitoring Service utilizes our proprietary automated tool along with subject matter expertise to ensure that both the universe criteria are met, and anomalies are detected and investigated prior to your CMS Audit.  BluePeak’s process includes the following for all CMS program audit areas:

  • Data Validation – checks for technical issues, such as blank cells, duplicate entries, incorrect formats, exclusion requirements, and inaccurately populated fields.
  • Identify Risk and Outliers – analyze universe data to identify potential operational issues, such as untimeliness, logical sequencing and unusual patterns that would be red flags to CMS auditors.
  • Updated with each new CMS Audit Protocol release or HPMS memo impacting Universe layouts and requirements
  • Insight into Industry wide best practices and CMS areas of focus during annual CMS Program Audits
  • Coach your team and your first-tier, downstream and related entities (FDRs) on accurate population of data or how to present the data.
  • BluePeak can also provide support during actual CMS timeliness monitoring reviews and CMS Program Audits.

Click Here to read a recent case study from a plan that benefitted from BluePeak’s UMS